Provider Demographics
NPI:1053891531
Name:SZESNAT, JAIMEE MICHELLE
Entity type:Individual
Prefix:
First Name:JAIMEE
Middle Name:MICHELLE
Last Name:SZESNAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21538 LONGWOOD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2102
Mailing Address - Country:US
Mailing Address - Phone:210-284-5278
Mailing Address - Fax:
Practice Address - Street 1:2739 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4811
Practice Address - Country:US
Practice Address - Phone:210-616-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212245208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation